MEDICARE: INNOCRE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1043166309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOCRE LLC

Provider Business Mailing Address
First Line	:	807 CATES WAY
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4119
Country	:	US
Telephone Number	:	267-234-8886
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 CATES WAY
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4119
Country	:	US
Telephone Number	:	267-234-8886
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ATUL SKARIYA VELLAPPALLY
Credential	:	CRNP
Telephone Number	:	267-234-8886

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “INNOCRE LLC ” Practice Location

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